Elite Supply Services, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ELITE SUPPLY SERVICES, INC.

Doing business as

Elite Group Warren

Practice address

2148 Bus-US 401
Raeford, NC 28376

Phone

(910) 565-2857

NPI assigned

May 18, 2020

Last updated

Mar 4, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Harry Lamont Southerland, JD

Title

President

Phone

(910) 978-9118

Specialties & licenses 2

Addresses

Other names 1

• Elite Group Warren Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1578185104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283760417",
            "fax_number": "910-248-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 BUS-US 401",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "28376",
            "telephone_number": "910-565-2857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 W Ridgeway St",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "NC",
            "postal_code": "275891715",
            "country_code": "US",
            "telephone_number": "910-978-9118",
            "fax_number": "910-248-6258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE SUPPLY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-978-9118",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Group Warren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ely Enterprises, Inc.

• Durable Medical Equipment & Medical Supplies in Raeford, NC
• Providers in Raeford, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.